Gov’t Filches Millions From
Its Senior Citizens
There has been much ado
about rising medical and health costs during the past decade, but little has
been said about the Medicare managers and how they work prodigiously to reduce
health care costs. Since Medicare in the
Title XVIII of the Social Security Act which is responsible for meeting out
funds for illness, it seems paradoxial that this same agency could be feted for
actually saving the government money.
But they do, by having
sharp-eyed clerks ferret out ways they can shortchange these who are issued by
Medicare.
I sought my friend,
Chisholm in the Medicare office to find out about all this.
“Are these rumors true?” I
asked, “That Prudential is saving millions on health bills by carefully
perusing each case and cutting out the excess monies that patients believe are
due them?”
“Probably true,” Chisholm
replied. “After subtracting our costs
there probably is a substantial profit for the government and that means for
the taxpayer.”
“But Chisholm,” I
remonstrated, “You might save a few pennies for each taxpayer, but at the cost
of depriving the sick person dollars, maybe even a hundred dollars.”
“Well, a penny saved is a
penny earned,” Chisholm replied brightly.
“But is it just?” I asked. “For instance, this very year I won several
cases against Medicare for my patients which they couldn’t possibly have won
for themselves, being neither lawyers nor doctors. I mean the issues are very complicated, and
the medical matters must be interpreted in the light of Medicare law. What makes it more difficult is that you are
never discussing the case with a doctor, but with some clerks. No doctors ever see the cases, but continue
to discuss the issues through the mails, even long after the patient is
dead. They never give up, Chisholm.”
“But the patient is
entitled to a fair hearing, why do you have to get involved?” Chisholm asked.
“Because the fair hearing
isn’t very fair,” I replied heatedly.
“Tut, tut, how can you say
that?” Chisholm sounded offended.
“Easy,” I replied, taking
out the latest letter from Prudential which providently had landed on my desk
that morning. “They or you, or Medicare
or Prudential, or whoever it is that I am arguing the case with, insists that
they have had their own medical staff review the charts, and that their opinion
is that the allowances are fair and equitable.
Then they offer me a fair hearing.
What is a fair hearing, but a contest between me and my patient against
Medicare, or Prudential, or whoever, before a Hearing Officer, who is a member
of the Prudential or Medicare or whoever’s staff. They tell me I can bring a lawyer. They also add that no claim for less than
$100 will be allowed a fair hearing. Do
you have any idea, Chisholm, how many millions – nay hundreds of millions –
dare I say billions, the government can filch from its senior citizens by
denying 50 bucks here and 30 bucks there?”
“Yup, it’s a lot of money,”
Chisholm said, smacking his lips.